Metformin effect on internal carotid artery blood flow assessed by area under the curve of carotid artery Doppler in women with polycystic ovarian syndrome

BACKGROUND Insulin resistance(IR)was reported in most polycystic ovarian syndrome(PCOS)cases.Metformin,a biguanide drug,successfully reduced IR.Homeostatic Model Assessment for IR(HOMA-IR)and Doppler parameters assessed metformin's effectiveness.AIM To verify whether the area under the curve of the internal carotid artery(AUC-ICA)Doppler wave can be a useful marker for assessing IR among PCOS cases who presented with menstrual irregularity and were treated with metformin over 6 mo.METHODS An observational,cross-sectional study recruited 54 eligible PCOS women;the anthropometrics were as follows:age,body mass index(BMI),menstrual cycle days,biochemical serum cholesterol,low and high-density lipoprotein,sex hormone-binding globulin,fasting blood glucose,and HOMA-IR,hormonal testosterone,luteinizing hormone over follicle-stimulating hormone ratio,and ultrasonic pulsatility index(PI)and resistance index(RI),carotid artery intima-media thickness(CIMT)and(AUC-ICA)parameters were initially recorded and repeated 3 mo and 6 mo later with metformin tab 500 mg;three times/day for 6 mo.In addition,AUC-ICA was assessed by taking repeated systolic and diastolic wave height measurements.RESULTS Metformin caused a progressive reduction in BMI,menstrual cycle days,biochemical hormonal,and Doppler parameters(CIMT,PI,RI,and AUC-ICA).AUC-ICA correlated strongly to all PCOS parameters.AUC-ICA correlated inversely with treatment time(r=-0.98,P<0.001)and positively with HOMA-IR(r=0.98,P<0.0001).Via the best subset regression model,the AUC-ICA had the highest predictive value for HOMA-IR.CONCLUSION AUC-ICA preceded PI,RI,and CIMT with a strong,meaningful correlation to all PCOS parameters,making it a reliable marker for the assessment of IR,especially during metformin therapy.Further studies are recommended to promote the application in practice.

Quality control of ultrasonic measurement of carotid artery intima-media thickness

Background To report quality control methods and baseline reproducibility data of the ultrasound measurements of carotid artery intima-media thickness in the project of Establishment of an Integrated System for Coronary Heart Disease Prevention and Treatment. Methods Standard ultrasound scanning and measuring protocols were established by the study group. All sonographers and readers were trained by the carotid ultrasound core lab and all digital ultrasound images were centrally read. Ten subjects were scanned twice （with 1 week interval） by 2 sonographers independently and images were read by a single reader to evaluate the sonographer variability. Twenty subjects＇ images were read twice （with 1 week interval） by a single reader to assess the reader variability and the reproducibility of IMT measured at different carotid segments. Results The intraclass correlation （ICC） of intra- and inter-sonographer and intra- reader for mean IMT measurements was 0.99, 0.98 and 0.97 respectively; while for max IMT, it was 0.97, 0.99 and 0.95 respectively. Among different carotid segments and sites, ICC for mean 1MT measurements of common carotid （CCA）, carotid artery bulb （Bulb）, internal carotid artery （ICA）, overall near wall and overall far wall was 0.97, 0.99, 0.89, 0.93 and 0.98 respectively. Conclusion The reproducibility of IMT measurements according to our protocol is acceptable, although better reproducibility is found when measuring the mean IMT than max IMT, CCA and Bulb IMT than ICA IMT, and far wall IMT than near wall IMT.

The Analysis of Wall Shear Stress Modulated by Acute Exercise in the Human Common Carotid Artery with an Elastic Tube Model

Assessment of the magnitude and pattern of wall shear stress(WSS)in vivo is the prerequisite for studying the quantitative relationship between exercise-induced WSS and arterial endothelial function.In the previous studies,the calculation of the WSS modulated by exercise training was primarily based upon the rigid tube model,which did not take non-linear effects of vessel elastic deformation into consideration.In this study,with an elastic tube model,we estimated the effect of a bout of 30-minute acute cycling exercise on the WSS and the flow rate in the common carotid artery according to the measured inner diameter,center-line blood flow velocity,heart rates and the brachial blood pressures before and after exercise training.Furthermore,the roles of exerciseinduced arterial diameter and blood flow rate in the change of WSS were also determined.The numerical results demonstrate that acute exercise significantly increases the magnitudes of blood flow rate and WSS.Moreover,the vessel elastic deformation is a non-negligible factor in the calculation of the WSS induced by exercise,which generates greater effects on the minimum WSS than the maximum WSS.Additionally,the contributions of exercise-induced variations in blood flow rate and diameter are almost identical in the change of the mean WSS.

Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome: A case report

BACKGROUND We report a rare case of numbness in the right hand,finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases.CASE SUMMARY The patient was a 65-year-old woman.She complained of dizziness,numbness and weakness of the right hand for 6 mo.She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound,enhanced computed tomography,computed tomography angiography and other examinations.Considering the surgical risks,the patient refused the aberrant right subclavian artery stent implantation and was discharged.We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations.CONCLUSION Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare.This case reminds interventional radiologists of the possibility of these abnormalities before surgery.

Evaluation of revascularization after total arch replacement in common carotid artery occlusion

Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.

Carotid-subclavian bypass and endovascular aortic repair of Kommerell’s diverticulum with aberrant left subclavian artery:A case report

BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.

Comparison of invasive dynamic blood pressure between superior mesenteric artery and common carotid artery in rats

BACKGROUND: The purpose of this study was to identify the consistency of invasive dynamic blood pressure(BP) monitoring between the superior mesenteric artery(SMA) and the common carotid artery(CCA).METHODS: Eight male Sprague-Dawley rats were cannulated in SMA and CCA simultaneously for BP monitoring, respectively.The abdominal aorta was prepared for the induction of BP change through clamping/de-clamping by a microvascular clip.The dynamic BP monitoring was performed by a polygraph system.Systolic blood pressure(SBP), diastolic blood pressure(DBP), and mean arterial pressure(MAP) values would be recorded during different time periods: the baseline(T1), the increasing period after clamping(T2), the platform period during clamping(T3), the decreasing period after de-clamping(T4), and the final platform period(T5).Three trials were performed on each rat with 15-minute intervals between consecutive monitoring.RESULTS: Systolic BP showed no significant differences between SMA and CCA.However, significant difference was found in diastolic blood pressure except at T5(P=0.534).Mean arterial pressure of two arteries were significantly different only at T1(P=0.015).The strength of association was significantly high between BP measurements through SMA and CCA(P<0.001).The BlandAltman analyses showed that mean bias of MAP changed no more than 5 mmHg and standard deviation less than 8 mmHg during T2 and T4, respectively.CONCLUSION: The study indicates SMA might be an alternative site for invasive BP monitoring during abdominal aorta occlusion and release, especially in cerebrovascular-related research.

Histochemistry of microinfarcts in the mouse brain after injection of fluorescent microspheres into the common carotid artery

The mouse model of multiple cerebral infarctions,established by injecting fluorescent microspheres into the common carotid artery,is a recent development in animal models of cerebral ischemia.To investigate its effectiveness,mouse models of cerebral infarction were created by injecting fluorescent microspheres,45–53μm in diameter,into the common carotid artery.Six hours after modeling,fluorescent microspheres were observed directly through a fluorescence stereomicroscope,both on the brain surface and in brain sections.Changes in blood vessels,neurons and glial cells associated with microinfarcts were examined using fluorescence histochemistry and immunohistochemistry.The microspheres were distributed mainly in the cerebral cortex,striatum and hippocampus ipsilateral to the side of injection.Microinfarcts were found in the brain regions where the fluorescent microspheres were present.Here the lodged microspheres induced vascular and neuronal injury and the activation of astroglia and microglia.These histopathological changes indicate that this animal model of multiple cerebral infarctions effectively simulates the changes of various cell types observed in multifocal microinfarcts.This model is an effective,additional tool to study the pathogenesis of ischemic stroke and could be used to evaluate therapeutic interventions.This study was approved by the Animal Ethics Committee of the Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences(approval No.D2021-03-16-1)on March 16,2021.

Common carotid arterial thrombosis associated with ulcerative colitis

A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient’s bowel disease.

Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis： a coronary artery calcium score and carotid intima-media thickness study

Background Thalassemic patients demonstrate an increased rate of extracardiae vascular complications and increased carotid wall intima-media thickness （cIMT）, but very low prevalence of coronary artery disease （CAD）. We investigated the atheroma burden by assessing the coronary artery calcium （CAC） and elMT in these patients. Methods We examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography （CT） and ultrasonography to determine CAC score and cIMT, respectively. Results Propensity score matching （C-statistic： 0.88; 95% CI： 0.83-0.93） resulted in 27 pairs of patients; severe CAC was observed in 2 （7.4%） and 0 of β-thalassemia patients and healthy volunteers respectively （P = 0.5）. Median calcium score was 0 （0-0） in β-thalassemia patients and 0 （0-4） in healthy volunteers （P = 0.8）. Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 （0.06-0.65） vs. 0.062 （0.054-0.086）; P = 0.04]. Conclusions Patients with β-thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence.

Congenital bilateral absence of the common carotid artery and internal carotid artery:a case report and literature review

Absence of the common carotid artery(CCA) and/or internal carotid artery (ICA ) is a kind of rare congenital anomaly. This paper reports one patient with bilateral absence of the CCA and ICA who suffered from cerebral infarction. And the relative literatures of the possible cause and collateral circulation were reviewed.

A REVIEW ON ARTERY WALL SEGMENTATION TECHNIQUES AND INTIMA-MEDIA THICKNESS MEASUREMENT FOR CAROTID ULTRASOUND IMAGES

Stroke and heart attack,which could be led by a kind of cerebrovascular and cardiovascular disease named as atherosclerosis,would seriously cause human morbidity and mortality.It is important for the early stage diagnosis and monitoring medical intervention of the atherosclerosis.Carotid stenosis is a classical atherosclerotic lesion with vessel wall narrowing down and accumulating plaques burden.The carotid artery of intima-media thickness(IMT)is a key indicator to the disease.With the development of computer assisted diagnosis technology,the imaging techniques,segmentation algorithms,measurement methods,and evaluation tools have made considerable progress.Ultrasound imaging,being real-time,economic,reliable,and safe,now seems to become a standard in vascular assessment methodology especially for the measurement of IMT.This review firstly attempts to discuss the clinical relevance of measurements in clinical practice at first,and then followed by the challenges that one has to face when approaching the segmentation of ultrasound images.Secondly,the commonly used methods for the IMT segmentation and measurement are presented.Thirdly,discussion and evaluation of different segmentation techniques are performed.An overview of summary and future perspectives is given finally.

Relationship between peripheral arterial disease, carotid intima-media thickness and C-reactive protein in elderly diabetic patients

Purpose: To study the association between carotid intima media thickness (CIMT) and high sensitivity CRP (hs-CRP) level as markers for PAD in elderly patients with DM. Subjects: A case-control study on 90 participants aged 60 years and older divided into 60 cases (30 patients with DM alone and 30 patients with DM and comorbidities) and 30 healthy controls. All were assessed by measuring CIMT, ankle brachial index (AB), and markers for cardiovascular disease such as high-sensitivity CRP (hs-CRP), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL). Results: hs-CRP levels showed statistically significant difference being highest among patients with DM and comorbidities and lowest among controls (P < 0.001). Also, symptoms of PAD were significantly higher among cases than controls. ABI was able to detect PAD in many asymptomatic patients. Color changes were present in only 43.30% (n = 26) of positive PAD cases while delayed wound healing, claudication pain, rest pain, cold extremities, and trophic changes were present in 23.30% (n = 14), 16.71% (n = 10), 16.71% (n = 10), 45.00% (n = 27), and 21.7% (n = 13). Using logistic regression analysis revealed that DM, CIMT, and hs-CRP were independent predictors for PAD (OR = 4.194, 7.236, 1.003;P value = 0.044, 0.25, 0.031) after adjustment of other coronary risk factors such as sex, smoking, hypertension, TC, and TG. Conclusion: Diabetic elderly have higher prevalence of asymptomatic PAD thannon-diabetics using solely ABI. DM, CIMT, and hs-CRP are independent predictors for the occurrence of PAD. Hs-CRP levels are highest among diabetics with comorbidities.

Lead to Elevate the Temperature and Speed of Emergency Rescue and Nursing Care of Common Carotid Artery Rupture and Massive Hemorrhage after Operation of Typical Esophageal Cancer

Objective:Objective To explore the first aid and nursing of patients with anastomotic fistula after radical resection of esophagus carcinoma complicated with major carotid hemorrhage.Methods:The clinical data of anastomotic fistula complicated with carotid artery rupture and massive hemorrhage after radical resection of typical esophageal carcinoma were analyzed and summarized.Results:Through the close cooperation of medical care,the rescue was successful.Conclusion:Earlier prevention observation,raising first aid consciousness and actively cooperating with doctors can improve the success rate of rescue.

Cerebral blood flow volume measurements of the carotid artery and ipsilateral branches using two-dimensional phase-contrast magnetic resonance angiography

The optimal velocity encoding of phase-contrast magnetic resonance angiography （PC MRA） in measuring cerebral blood flow volume （BFV） ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional （2D） PC MRA, the present study localized the region of interest at blood vessels of the neck using PC MRA based on three-dimensional time-of-flight sequences, and the velocity encoding was set to 80 cm/s. Results of the measurements showed that the error rate was 7.0±6.0% in the estimation of BFV in the internal carotid artery, the external carotid artery and the ipsilateral common carotid artery. There was no significant difference, and a significant correlation in BFV between internal carotid artery ＋ external carotid artery and ipsilateral common carotid artery. In addition, the BFV of the common carotid artery was correlated with that of the ipsilateral internal carotid artery. The main error was attributed to the external carotid artery and its branches. Therefore, after selecting the appropriate scanning parameters and protocols, 2D PC MRA is more accurate in the determination of BFV in the carotid arteries.

颈总动脉流速对创伤合并休克患者容量反应性的评价

目的探讨颈总动脉呼气末及吸气末流速对评估创伤合并休克患者容量反应性的意义。方法前瞻性研究2017年7月—2019年1月上海市浦东新区人民医院重症监护室收治需要机械通气控制呼吸的创伤合并休克患者60例,根据液体复苏后是否具有容量反应性(VR)且扩容前后心输出量(CO)变化是否≥15%将患者分为有反应(VR+组)及无反应(VR-组),各30例。VR+组男性23例,女性7例;年龄18~86岁,平均46.9岁。VR-组男性21例,女性9例;年龄18~90岁,平均46.1岁;采用迈瑞M9便携式多普勒超声取右颈总动脉长轴方向上测量两组患者呼气末最大血流速度(ex-Vmax)、吸气末最大血流速度(in-Vmax)与呼气末平均血流流速(ex-TAmax)、吸气末平均血流流速(in-TAmax),并计算出各自的变异度值:颈总动脉吸呼气末最大血流速度变异度(△Vmax)、吸呼气末平均血流速度变异度(△TAmax),分析不同组别上述数值的变化;绘制受试者工作特征(ROC)曲线,分析以上各项指标在容量反应性评估方面的价值。结果VR+组与VR-组in-Vmax[(71.72±18.67)cm/s vs.(79.47±24.04)cm/s]、in-TAmax[(40.67±11.44)cm/svs.(46.44±15.84)cm/s]比较无明显差异,但ex-Vmax[(61.00±17.84)cm/s vs.(76.86±25.28)cm/s]、ex-TAmax[(34.83±11.01)cm/s vs.(44.66±15.43)cm/s]比较差异有统计学意义(P<0.05)。VR+组与VR-组△Vmax(19.42%±14.18%vs.5.09%±13.59%)、△TAmax(18.19%±11.63%vs.4.29%±7.57%)比较差异有统计学意义(P<0.001)。ex-Vmax与ex-TAmax对创伤合并休克患者容量评估的ROC曲线下面积分别为0.695和0.678,而△Vmax与△TAmax的ROC曲线下面积均>0.800,分别是0.803和0.863,提示△Vmax、△TAmax对于创伤合并休克患者容量的评估更敏感。结论呼气末颈总动脉最大血流流速及平均血流流速、吸呼气末最大血流流速差异度及平均血流流速变异度均可用来评估机械通气创伤合并休克患者的容量反应性,且吸呼气末最大血流流速变异度及平均血流流速变异度对容量反应性的评估效果更佳。

急性脑梗死患者血清CTRP3及CTRP9水平与颈总动脉内膜中层厚度的相关性分析

目的 探讨急性脑梗死患者血清C1q/肿瘤坏死因子相关蛋白(CTRP)3和CTRP9水平与颈总动脉内膜中层厚度(IMT)的相关性。方法 前瞻性纳入2020年12月至2023年5月河北北方学院附属第一医院收治的急性脑梗死患者87例作为观察组,另选取同期在该院体检的健康者85名作为对照组。采用酶联免疫吸附试验法检测两组研究对象血清中CTRP3、CTRP9水平,并通过彩色多普勒超声系统测量颈总动脉IMT。比较两组研究对象的血清CTRP3、CTRP9水平及颈总动脉IMT,比较两组研究对象的颈总动脉硬化程度,不同动脉硬化程度急性脑梗死患者血清CTRP3、CTRP9水平,分析血清CTRP3,CTRP9水平与急性脑梗死患者颈总动脉IMT的相关性。结果 观察组患者的血清CTRP3、CTRP9水平分别为(238.34±65.23)、(138.34±52.65)ng/mL,均明显低于对照组[(372.14±83.47)、(249.25±78.32)ng/mL],颈总动脉IMT为(1.34±0.41) mm,显著高于对照组[(0.74±0.12)mm],差异均有统计学意义(P<0.05)。观察组患者的颈总动脉硬化程度正常占比为9.20%,明显低于对照组(72.94%),内膜增厚和斑块形成占比分别为31.03%、57.47%,均明显高于对照组(17.64%、9.41%),差异均有统计学意义(P<0.05)。随着颈总动脉IMT的增加,血清CTRP3和CTRP9的水平显著降低,差异均有统计学意义(P<0.05)。血清CTRP3和CTRP9水平与颈总动脉IMT均呈负相关(r=-0.461、-0.592,P<0.05),而CTRP3和CTRP9之间呈正相关(r=0.498,P<0.05)。结论 急性脑梗死患者血清CTRP3和CTRP9水平与颈总动脉IMT有明显负相关性。CTRP3和CTRP9可能作为动脉粥样硬化和急性脑梗死的潜在生物标志物,为临床预测和干预缺血性脑卒中提供重要信息。

川芎-天麻对血管性认知障碍大鼠学习记忆的改善作用研究

为探讨川芎-天麻提取物对血管性认知障碍(VCI)大鼠学习记忆的改善作用及机制。本研究采用两血管阻断法(Two-vessel occlusion,2-VO)复制VCI模型,造模成功后随即分为模型组、阳性药组、高剂量组、低剂量组和假手术组。假手术组、模型组灌服蒸馏水,阳性药组灌服0.45 mg/(kg·d)盐酸多奈哌齐,高、低剂量组分别以3 g/(kg·d)、1.5 g/(kg·d)灌服提取物,给药56 d后,水迷宫和社交行为检测各组大鼠行为学;ELISA法检测乙酰胆碱含量和乙酰胆碱脂酶活性。结果表明,与假手术组比较,模型组大鼠空间学习记忆能力、探索能力和社交能力下降;水迷宫试验结果显示,逃避潜伏期明显延长(P <0.01),穿越平台次数明显缩短(P <0.01);社交行为结果显示,接触时间和接触次数显著减少(P<0.05);脑内乙酰胆碱表达水平下调,乙酰胆碱酯酶活力值表达水平上调(P<0.05)。与模型组比较,高剂量组大鼠空间学习记忆能力、探索能力和社交能力明显改善,表现为逃避潜伏期明显缩短,穿越平台次数及在原平台停留时间均明显增加,社交接触时间和接触次数显著增加(P<0.05)。脑内乙酰胆碱表达水平上调和乙酰胆碱酯酶表达水平下调(P <0.05)。川芎-天麻提取物可干预大鼠脑内乙酰胆碱表达,改善VCI大鼠学习与记忆能力。

颈总动脉交感神经网剥脱术对混合型脑性瘫痪临床疗效及血清IL-6、IL-10、TNF-α水平的影响

目的探讨颈总动脉交感神经网剥脱术对混合型脑性瘫痪儿童临床疗效及血清炎性细胞因子的影响。方法对50例混合型脑性瘫痪儿童行颈总动脉交感神经网剥脱术,比较手术前后白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及改良Ashworth痉挛评分、教师流涎(teacher drooling scale,TDS)分级和粗大运动功能分类系统(gross motor function classification system,GMFCS)改善情况。结果50例混合型脑性瘫痪儿童术后IL-6、TNF-α水平较术前降低,差异有统计学意义(P<0.05);术后IL-10水平较术前差异无统计学意义(P>0.05)。术后改良Ashworth痉挛评分及TDS分级较术前改善,差异有统计学意义(P<0.05);术后GMFCS程度较术前无改善,差异无统计学意义(P>0.05)。手术前后TNF-α水平与改良Ashworth痉挛评分及TDS分级均呈正相关,手术前后TNF-α水平与GMFCS程度无相关性;手术前后IL-6、IL-10水平与改良Ashworth痉挛评分、TDS分级、GMFCS程度均无相关性。结论IL-6、IL-10、TNF-α参与了混合型脑性瘫痪的发病过程,而颈总动脉外膜交感神经网剥脱术可通过降低IL-6、TNF-α水平达到改善临床症状的效果,值得推广应用。